OP-192: THE RELATIONSHIP BETWEEN MEAN PLATELET VOLUMES AND IN HOSPITAL MORTALITY RISKS DETERMINED BY GRACE RISK SCORE IN PATIENTS WITH ACUTE ST SEGMENT ELEVATION MYOCARDIAL INFARCTION PATIENTS

In emergency clinical settings, it may be beneficial to use rapidly measured objective variables for the risk assessment for patient outcome. This study sought to develop an easy-to-measure and objective risk-score prediction model for in-hospital mortality in patients with ST-segment elevation myocardial infarction (STEMI). A total of 1027 consecutive STEMI patients were recruited and divided into derivation (n = 669) and validation (n = 358) cohorts. A risk-score model was created based on the combination of blood test parameters obtained immediately after admission. In the derivation cohort, multivariate analysis showed that the following 5 variables were significantly associated with in-hospital death: estimated glomerular filtration rate <45 mL/min/1.73 m2, platelet count <15 × 104/μL, albumin ≤3.5 g/dL, high-sensitivity troponin I >1.6 ng/mL, and blood sugar ≥200 mg/dL. The risk score was weighted for those variables according to their odds ratios. An incremental change in the scores was significantly associated with elevated in-hospital mortality (p < 0.001). Receiver operating characteristic curve analysis showed adequate discrimination between patients with and without in-hospital death (derivation cohort: area under the curve (AUC) 0.853; validation cohort: AUC 0.879), and there was no significant difference in the AUC values between the laboratory-based and Global Registry of Acute Coronary Events (GRACE) score (p = 0.721). Thus, our laboratory-based model might be helpful in objectively and accurately predicting in-hospital mortality in STEMI patients.

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Simple risk score based on the China Acute Myocardial Infarction registry for predicting in-hospital mortality among patients with non-ST-segment elevation myocardial infarction: results of a prospective observational cohort study

BMJ Open ◽

10.1136/bmjopen-2019-030772 ◽

2019 ◽

Vol 9 (9) ◽

pp. e030772 ◽

Cited By ~ 1

Author(s):

Chenxi Song ◽

Rui Fu ◽

Sidong Li ◽

Jingang Yang ◽

Yan Wang ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Hospital Mortality ◽

Risk Score ◽

Smoking Status ◽

Laboratory Data ◽

Discrimination Ability ◽

St Segment Elevation ◽

Segment Elevation Myocardial Infarction ◽

St Segment

ObjectivesTo simplify our previous risk score for predicting the in-hospital mortality risk in patients with non-ST-segment elevation myocardial infarction (NSTEMI) by dropping laboratory data.DesignProspective cohort.SettingMulticentre, 108 hospitals across three levels in China.ParticipantsA total of 5775 patients with NSTEMI enrolled in the China Acute Myocardial Infarction (CAMI) registry.Primary outcome measuresIn-hospital mortality.ResultsThe simplified CAMI-NSTEMI (SCAMI-NSTEMI) score includes the following nine variables: age, body mass index, systolic blood pressure, Killip classification, cardiac arrest, ST-segment depression on ECG, smoking status, previous angina and previous percutaneous coronary intervention. Within both the derivation and validation cohorts, the SCAMI-NSTEMI score showed a good discrimination ability (C-statistics: 0.76 and 0.83, respectively); further, the SCAMI-NSTEMI score had a diagnostic performance superior to that of the Global Registry of Acute Coronary Events risk score (C-statistics: 0.78 and 0.73, respectively; p<0.0001 for comparison). The in-hospital mortality increased significantly across the different risk groups.ConclusionsThe SCAMI-NSTEMI score can serve as a useful tool facilitating rapid risk assessment among a broader spectrum of patients admitted owing to NSTEMI.Trial registration numberNCT01874691.

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